Provider Demographics
NPI:1992099063
Name:SKAR, GWENN L (MD)
Entity type:Individual
Prefix:DR
First Name:GWENN
Middle Name:L
Last Name:SKAR
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:UNMC DEPARTMENT OF PEDIATRICS
Mailing Address - Street 2:982165 NEBRASKA MEDICAL CENTER
Mailing Address - City:OMAHA
Mailing Address - State:NE
Mailing Address - Zip Code:68198-2165
Mailing Address - Country:US
Mailing Address - Phone:402-559-6400
Mailing Address - Fax:
Practice Address - Street 1:UNMC DEPARTMENT OF PEDIATRICS
Practice Address - Street 2:982165 NEBRASKA MEDICAL CENTER
Practice Address - City:OMAHA
Practice Address - State:NE
Practice Address - Zip Code:68198-2165
Practice Address - Country:US
Practice Address - Phone:402-559-6400
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2011-06-06
Last Update Date:2015-04-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NE27894208000000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208000000XAllopathic & Osteopathic PhysiciansPediatrics